Dynamic change of myogenin in denervated rat mimetic muscle.

We previously reported double innervation of rat mimetic muscles with labeling of facial nuclei. However, whether denervated mimetic muscles are affected after such nerve repair is not known. Rats were divided into five groups: Group A, controls; Group B, complete facial palsy; Group C, complete facial palsy with repair using end-to-end neurorrhaphy; Group D, incomplete facial palsy; and Group E, incomplete facial palsy with repair using end-to-side neurorrhaphy. Preoperatively and postoperatively, facial palsy and myogenin (Myog) expression in mimetic muscles were evaluated. Expression peaked on day 7 in Group B but was lower in Groups C and D. Expression in Groups D and E was comparable on day 28, and each model's score showed characteristic changes. Myog expression in facial mimetic muscles increases with denervation and decreases with nerve repair. Determining Myog expression levels in mimetic muscles just after nerve repair may help surgeons predict postoperative prognosis in facial palsy.

Combined therapy of NPWT and bipedicled flap as an alternative approach for giant abdominal wall defect with significant visceral edema: report of a case.

Open abdomen management is commonly used for the critically injured patients to avoid abdominal compartment syndrome. But it usually continues for days to weeks and finally results in abdominal wall defect that is too wide to close at once. This article presents an alternative approach to close the giant abdominal wall defect by using the combination of bipedicled flaps with the components separation technique and V.A.C.® system.

[A cranial reconstruction using an autologous split calvarial bone combined with a free graft of temporal loose areolar tissue].

We report a new simple method of cranial reconstruction using an autologous split calvarial bone, combined with free graft of temporal loose areolar tissue. A 58-year-old woman suffered from a cranium defect on her left side. The originating bone infection happened after initial brain tumor surgery. Part of the left side of her scalp just above the damaged cranial area had become very thin due to previous cranioplasty, which involved a titanium mesh plate and postoperative infections. We performed a cranial reconstruction with an autologous split calvarial bone, combined with loose areolar tissue free graft, for the damaged area with skin from the inner side. In our case, we expect that the addition of the free graft of loose areolar tissue to the autologous calvarial bone graft will effectively contribute to the skin's healing and provide good cosmetic results in our short follow-up period. A free graft of loose areolar tissue for the damaged skin area may be a new optional method for cranial reconstruction in a patient with skin trouble.

Occult lacerations to the epiglottis and pharynx by glass fragments.

Injury to the epiglottis and pharynx is very rare in neck trauma overall. We experienced such a rare case in which a 43-year-old woman had lacerations to the epiglottis and pharynx. It was difficult to determine the exact site of the damage by observing the cut. We believed there was no damage to the lower respiratory tract because her vital signs were stable and her consciousness was clear. However, initial computed tomography revealed emphysema and showed that fragments from a glass vase had pierced the posterior pharyngeal wall.